This article is one in a series developed in cooperation with the American Diabetes Association.

DKA Protocol

Am J Med Sci. Guest editors of the series are Bruce Zimmerman, M. Regular insulin should be used intravenously. Either of these treatments should be continued until the blood glucose level falls by 50 to 70 mg per dL. Half of the fluid resuscitation volume is initially replaced quickly over the first eight hours, with the rest being administered over the next sixteen hours.

When the blood glucose concentration is approximately mg per dL The insulin and fluid regimens are continued flowseet ketoacidosis is controlled. Initial presentation of diabetes mellitus.

Prevention of hypophosphatemia by phosphate infusion during treatment of diabetic ketoacidosis and hyperosmolar coma. The osmotic diuresis can cause a significant loss of fluid, leading to severe dehydration and circulatory collapse.

Therefore, they have fewer ketones available for the regeneration of bicarbonate during insulin administration.

Diabetic Ketoacidosis – – American Family Physician

Guest editor of the series is Eric Henley, M. This content is owned by the AAFP. If surgery is necessary, the timing needs to be individualized for each patient with input from a surgical consultant. Information from references 4 through A randomized study of phosphate therapy in the treatment of diabetic ketoacidosis.

This dreaded treatment complication occurs in approximately 1 percent of children with diabetic ketoacidosis.

Managing Diabetic Ketoacidosis: Eight Steps of ACT-RAPID | AUSMED

B 383940 Low phosphate levels can cause problems, but phosphate does not need to be given routinely. DKA is caused by reduced insulin levels, decreased glucose use, and increased gluconeogenesis from dja counter regulatory hormones, including catecholamines, glucagon, and cortisol. For this reason, there are varying degrees of severity with DKA: Cerebral oedema during treatment of diabetic ketoacidosis: The amount of fluid resuscitation required in severe DKA is often the amount of fluid that is lost around six to ten litres.

The management of patients with diabetic ketoacidosis includes obtaining a thorough but rapid history and performing a physical examination in an attempt to identify possible precipitating factors.

Pickup J, Keen H. Although the phosphate level frequently is low in patients with DKA, good-quality studies have shown that routine phosphate replacement does not improve outcomes in DKA, and excessive replacement can lead to hypocalcemia.

When should determination of ketonemia be recommended? Blood urea nitrogen and creatinine. It also leads to a diuresis in which water losses exceed sodium chloride losses.

This website uses cookies to improve your experience. We'll assume you're ok with this, but you can opt-out if you wish. Cookie settingsACCEPT

Privacy & Cookies Policy

Privacy Overview

This website uses cookies to improve your experience while you navigate through the website. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are as essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may have an effect on your browsing experience.

This website uses cookies to improve your experience while you navigate through the website. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are as essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may have an effect on your browsing experience.

Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.

Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. It is mandatory to procure user consent prior to running these cookies on your website.